Jane Macnaughton writes from Montevideo:When you enter the Respira Uruguay exhibition it is as if you have slipped into the wide thoracic cavity of a large mammal, ribs open to the air and readily able to expand and contract with each breath. The inside of the rib cage is decorated with the picture of a young boy running joyfully in the open air, chasing a dandelion clock that has been scattered by the breeze – the image of the exhibition.

Inside the Ribs

Our group, comprising four members of Durham’s Smoking Interest Group, a group of five young people from W-West, a young people’s tobacco control advocacy group from Glasgow, two youth development leaders from the NHS and ASH-Scotland, are being shown round the exhibition by its creator and director of the Science Centre (Espacio Cientia) in Montevideo, Martha Cambre. Martha explained to us that the exhibition was the result of a happy confluence of circumstances including the fact that the new President of Uruguay in 2005, President Vasquez, was an oncologist, deeply interested in preventing cancers and keen on public health. His interest and enthusiasm enabled Martha and her contacts in CIET, the tobacco control organisation in Uruguay to gain funding to put together the exhibition.

The exhibit is thus informed both by clinical information and artistic inspiration. Once inside the rib cage, you are presented incentives to start smoking written the outside of four doors. These are: ‘all your friends smoke so why not?’, ‘you can easily stop again if you start’, ‘it makes you look cool’ and ‘you are old enough to decide for yourself’ – all known reasons why young people start to smoke. If you succumb to an incentive and push open a door you enter a dark, low ceilinged space, very unlike the bright open space you have left and are confronted with a ticking clock informing you of the number of people who have died in Uruguay since the opening of the exhibition from a smoking-related disease: one every 90 minutes. As Brian Pringle (from Ash-Scotland) noted, this is the same number as in Scotland. Now, of course, you start to think again about the smoking life and try to leave it, but this is difficult. Only one of the four doors to the open air will open to let you out. As our youngest participant (Euan Russell, aged 9) commented, ‘I felt trapped. I wanted to get out but couldn’t’. As we watched Martha speaking to us in the smoking space, UV light played about her face greenly illuminating her sclera and teeth and aging her skin, reminding us of the effects of smoking on the body.

We did escape, eventually (much to Euan’s delight!), to have our senses further beset by the problems of smoking. A rack of clothing emits the unpleasant smells of a night in a smoky atmosphere, compared with those out in the fresh air. You can put you hand out to feel the strength of air being expelled from a non-smoker’s lung and compare it with that from a smoker’s lung. The difference is accentuated by sticky tar over the smoker’s lung which gums up you fingers, just as it might the alveoli. You can play a game of Russian roulette with you chances of getting a terminal illness as a smoker, and a chart reminds us of the costs of smoking a pack of 20 by day, week, month, year, decade, and what that might otherwise buy. ‘Here’s a cheque’, Martha said to us, handing over some pre-written cheque books, ‘what would you rather spend your money on?’ You can step onto a treadmill and measure the power you need as a smoker or as a non-smoker to walk up a steep hill. In the heat of Montevideo, I know which I would prefer! A tube depicting a cigarette illuminates in sections along its length showing 16 surprising elements contained in cigarettes, including poisons such as arsenic and cadmium. More surprising still is the temperature recorded at the burning tip: 900 degrees centigrade!

As we went round, it was noticeable how engaged our young group were, despite the challenges of language. They got the message of the doors, were able to interact with the sensory exhibits and puffed and panted on the treadmill. In discussions afterwards ideas on how to adapt the exhibition for a UK (Glasgow) audience came fast and furious from our inspired group. They wanted an ‘age your face’ computer simulation to show the effects of smoking on appearance; they were keen to emphasise more the environmental effects of smoking; and they wanted to highlight the insidious effects of packaging in attracting young smokers. They are all aware of the current proposals on plain packaging for cigarettes. These are all good thoughts to take with us as we move into a series of meetings with CIET, the British Embassy, and to fuel our appearance on a Uruguayan TV show on Friday morning!

To read more about the Smoking Interest Group’s Uruguay research trip, click here.

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About Jane Macnaughton

Jane is professor of Medical Humanities at Durham University and co-Director of the Centre for Medical Humanities. She has research interests in the nature of the clinical encounter and intersubjectivities within it, in the phenomenology of smoking, and in the methodology of interdisciplinarity within medical humanities. She is a also a clinician working in gynaecology. She is married to Andrew Russell, and they have a son, Euan (9), Jane's stepson, Ben (20) and a border terrier dog called Bertie.